Background Infectious diseases may rival cancer, heart disease, and chronic lung disease as sources of morbidity and mortality from smoking. We reviewed mechanisms by which smoking increases the risk of infection and the epidemiology of smoking-related infection, and delineated implications of this increased risk of infection among cigarette smokers. Methods The MEDLINE database was searched for articles on the mechanisms and epidemiology of smoking-related infectious diseases. English-language articles and selected cross-references were included. Results Mechanisms by which smoking increases the risk of infections include structural changes in the respiratory tract and a decrease in immune response. Cigarette smoking is a substantial risk factor for important bacterial and viral infections. For example, smokers incur a 2- to 4-fold increased risk of invasive pneumococcal disease. Influenza risk is severalfold higher and is much more severe in smokers than nonsmokers. Perhaps the greatest public health impact of smoking on infection is the increased risk of tuberculosis, a particular problem in underdeveloped countries where smoking rates are increasing rapidly. Conclusions The clinical implications of our findings include emphasizing the importance of smoking cessation as part of the therapeutic plan for people with serious infectious diseases or periodontitis, and individuals who have positive results of tuberculin skin tests. Controlling exposure to secondhand cigarette smoke in children is important to reduce the risks of meningococcal disease and otitis media, and in adults to reduce the risk of influenza and meningococcal disease. Other recommendations include pneumococcal and influenza vaccine in all smokers and acyclovir treatment for varicella in smokers.

https://jamanetwork.com/journals/jamainternalmedicine/articlepdf/217624/ira30766.pdf

Cigarette smoking and infection.

Organophosphorus flame retardants and plasticizers: sources, occurrence, toxicity and human exposure.

Review of relationship between indoor and outdoor particles: I/O ratio, infiltration factor and penetration factor

A growing body of empirical evidence is revealing the value of nature experience for mental health. With rapid urbanization and declines in human contact with nature globally, crucial decisions must be made about how to preserve and enhance opportunities for nature experience. Here, we first provide points of consensus across the natural, social, and health sciences on the impacts of nature experience on cognitive functioning, emotional well-being, and other dimensions of mental health. We then show how ecosystem service assessments can be expanded to include mental health, and provide a heuristic, conceptual model for doing so.

Nature and mental health: An ecosystem service perspective.

Results of recent research show that particulate matter (PM) composition and size vary widely with both space and time. Despite the variability in PM characteristics, which are believed to influence human health risks, the observed relative health risk estimates per unit PM mass falls within a narrow range of values. Furthermore, no single chemical species appears to dominate health effects; rather the effects appear to be due to a combination of species. Non-PM factors such as socioeconomic status and lifestyle are also believed to affect the health risk, although accounting for these confounding factors is challenging. Airborne PM is also responsible for a number of effects aside from human health, such as alterations in visibility and climate. Because the PM problem is associated with a range of societal issues such as energy production and economic development, making progress on reducing the effects of PM will require integrated strategies that bring together scientists and decision makers from diffe...

https://www.tandfonline.com/doi/pdf/10.1080/02786820500191348

Airborne Particulate Matter and Human Health: A Review

Because human activities impact the timing, location, and degree of pollutant exposure, they play a key role in explaining exposure variation. This fact has motivated the collection of activity pattern data for their specific use in exposure assessments. The largest of these recent efforts is the National Human Activity Pattern Survey (NHAPS), a 2-year probability-based telephone survey ( n=9386) of exposure-related human activities in the United States (U.S.) sponsored by the U.S. Environmental Protection Agency (EPA). The primary purpose of NHAPS was to provide comprehensive and current exposure information over broad geographical and temporal scales, particularly for use in probabilistic population exposure models. NHAPS was conducted on a virtually daily basis from late September 1992 through September 1994 by the University of Maryland's Survey Research Center using a computer-assisted telephone interview instrument (CATI) to collect 24-h retrospective diaries and answers to a number of personal and exposure-related questions from each respondent. The resulting diary records contain beginning and ending times for each distinct combination of location and activity occurring on the diary day (i.e., each microenvironment). Between 340 and 1713 respondents of all ages were interviewed in each of the 10 EPA regions across the 48 contiguous states. Interviews were completed in 63% of the households contacted. NHAPS respondents reported spending an average of 87% of their time in enclosed buildings and about 6% of their time in enclosed vehicles. These proportions are fairly constant across the various regions of the U.S. and Canada and for the California population between the late 1980s, when the California Air Resources Board (CARB) sponsored a state-wide activity pattern study, and the mid-1990s, when NHAPS was conducted. However, the number of people exposed to environmental tobacco smoke (ETS) in California seems to have decreased over the same time period, where exposure is determined by the reported time spent with a smoker. In both California and the entire nation, the most time spent exposed to ETS was reported to take place in residential locations.

/pdf/the-national-human-activity-pattern-survey-nhaps-a-resource-30rgkl94sv.pdf

The National Human Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants.

Vaccination, illness, and smoking history were compiled for a young adult male population. The relationship of cigarette smoking to hemagglutination inhibition antibody response after exposure to a new antigen was assessed in serum specimens collected from 289 volunteers after the 1968 A2/Hong Kong/68 influenza epidemic. Titers were minimally increased among smokers who were sick compared with those of nonsmokers. Among smokers who remained well, titers were significantly increased, probably because of more frequent subclinical infection. The persistence of hemagglutination inhibition antibody after natural infection or vaccination with A2 antigens was significantly decreased among cigarette smokers, as were titers two weeks after vaccination. Serologic response to vaccination did not significantly differ between smoking groups. Smoking, vaccine history, and morbidity status during an influenza epidemic were significant factors in explaining variations in hemagglutination inhibition antibody titers.

Cigarette smoking and hemagglutination inhibition response to influenza after natural disease and immunization.

Studies carried out in four distinct geographic areas of the United States involving 20,472 children and adults clearly linked excessive, acute respiratory disease with communities heavily polluted with sulfur dioxide and suspended sulfates. Pollution exposure of three years or longer was an important component in increased risk for acute respiratory disease. Laryngo- tracheobronchitis was the major condition productive of excess, acute, lower-respiratory disease in children in heavily polluted communities in the Salt Lake Basin and Rocky Mountain communities. The effect of pollution on excess, acute respiratory disease was found to be independent of socioeconomic status and cigarette smoking.

The Effect of Sulfur Dioxide and Suspended Sulfates on Acute Respiratory Disease

https://projecteuclid.org/download/pdf_1/euclid.bsmsp/1200514703

William C. Nelson

Papers

The National Human Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants.

Cigarette smoking and hemagglutination inhibition response to influenza after natural disease and immunization.

The Effect of Sulfur Dioxide and Suspended Sulfates on Acute Respiratory Disease

Statistical aspects of a community health and environmental surveillance system

Confidentiality and freedom of information for epidemiological data in governmental research.